2015-2017年四川省人民医院血培养病原菌分布及耐药性变迁  

Distribution of pathogenic agents and antimicrobial resistance trends in blood culture,2015-2017

作　　者：蒋小燕[1] 喻华[1] 梁敏[1] 刘鑫[1] JIANG Xiao-yan;YU Hua;LIANG Min;LIU Xin(Department of Laboratory,Sichuan Province People's Hospital,Sichuan Academy of Medical Sciences,Chengdu,Sichuan 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院检验科

出　　处：《现代预防医学》2019年第13期2455-2458,共4页Modern Preventive Medicine

摘　　要：目的分析2015-2017年四川省人民医院血培养病原菌分布及耐药性变迁。方法使用Bact-ALERT3D全自动血培养仪对标本进行培养,采用VITEK-2Compact全自动细菌鉴定及药敏系统和纸片法鉴定病原菌对药物的敏感性。结果2015-2017年该院血培养阳性率为11.67%(1458/12498),包括793株革兰阴性菌株占54.39%,561株革兰阳性菌株占38.48%,和104株真菌占7.13%。耐碳青霉烯类抗菌药物的肺炎克雷伯菌增加明显。铜绿假单胞菌对碳青霉烯类抗菌药物耐药率稳定(约25%)。鲍曼不动杆菌对常见抗菌药物的耐药性较高。MRSA和MRCNS的分离率分别为29.27%、85.47%。革兰阳性菌对万古霉素和利奈唑胺保持了较好的敏感性。结论本院2015-2017年血培养分离菌以革兰阴性菌为主,主要革兰阴性菌耐药率有上升趋势。Objective To analyze the distribution and drug resistance of the pathogens isolated from blood culture in the Sichuan province people's hospital from 2015 to 2017.Methods The specimens of blood and bone barrow were cultured by Bact-ALERT 3D automated blood culture system.VITEK-2 Compact and MIC test were used to detect the drug sensitivity of bacterial isolates from blood and bone marrow cultures.Results The positive rate of the blood culture was 11.67%(1 458/12 498).1458 strains were isolated for the first time from 2015 to 2017,including 793 strains of gram-negative bacteria(54.39%)and 561 strains of gram-positive bacteria(38.48%).Carbapenem resistant K.pneumoniae increased significantly.The resistance rate of Pseudomonas aeruginosa to carbapenem was relatively stable,approximately 25%for 3 years.The resistance rates of A.baumannii strains to most microbial agents were high.The prevalence of methicillin-resistant strain was 29.27%in S.aureus(MRSA)and 85.47%in CNS(MRCNS).Gram-positive bacteria maintained good sensitivity to vancomycin and linezolid.Conclusion The main pathogen of blood culture is Gram-negative bacteria,and there is an uptrend in the main gram negative bacteria.It is obliged to guide clinical rational drug use.

关 键 词：血培养 病原菌分布 耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]